Annals of hepatology最新文献

{"title":"New steatotic liver disease criteria diagnostic performance in an agricultural population in Chile.","authors":"Maria Spencer-Sandino, Franco Godoy, Laura Huidobro, Danilo Alvares, Francisco Cruz, Claudia Marco, Macarena Garrido, Daniel Cabrera, Juan Pablo Arab, Marco Arrese, Francisco Barrera, Catterina Ferreccio","doi":"10.1016/j.aohep.2025.101919","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101919","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This study aims to assess the performance of Steatotic Liver Disease (SLD) criteria in identifying liver steatosis compared to the NAFLD and MAFLD definitions in an agricultural population in Chile.</p><p><strong>Patients and methods: </strong>We performed a cross-sectional analysis on the MAUCO cohort, composed of 9,013 individuals aged 38 to 74. Health conditions, socio-demographics, anthropometrics, hepatic ultrasonography, blood pressure, and biological samples were obtained. Participants were classified as NAFLD, MAFLD, or any of the five SLD categories: Metabolic dysfunction-associated steatosis liver disease (MASLD), Metabolic and Alcohol-Associated Liver Disease (MetALD), Alcohol-Associated Liver Disease (ALD), Specific aetiologies, and Cryptogenic. The Framingham cardiovascular risk score and BARD liver fibrosis score were used to assess clinical relevance.</p><p><strong>Results: </strong>Liver steatosis was present in 4,082 participants (45%); SLD criteria captured an additional 176 individuals not classified under NAFLD and 103 not included under MAFLD definition. The main SLD subgroups were MASLD (95%), MetALD (1.9%) and ALD (1.3%). Individuals classified in the MetALD and ALD subgroups exhibited more severe liver steatosis and a higher cardiovascular risk. Notably, participants categorized under specific etiologies and cryptogenic subgroups were younger and had a higher risk for liver fibrosis.</p><p><strong>Conclusions: </strong>The study reveals that SLD offers a more inclusive classification to identify high-risk individuals in the Chilean population, capturing cases that could be missed by NAFLD or MAFLD definitions by using the same resources.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101919"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hepatitis B surface antigen quantification on achieving a functional cure in patients with chronic hepatitis B: A systematic review and meta-analysis","authors":"Shun Li ,&nbsp;Lichen Shi ,&nbsp;Cheng Huang ,&nbsp;Min Li ,&nbsp;Tongtong Meng ,&nbsp;Hao Wang ,&nbsp;Xinyu Zhao ,&nbsp;Xiaoqian Xu ,&nbsp;Hong You ,&nbsp;Jidong Jia ,&nbsp;Yuanyuan Kong","doi":"10.1016/j.aohep.2025.101921","DOIUrl":"10.1016/j.aohep.2025.101921","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Baseline hepatitis B surface antigen (HBsAg) levels are associated with the likelihood of achieving HBsAg loss which defines a functional cure. However, optimal HBsAg cut-offs for predicting HBsAg loss have not been systematically investigated. Therefore, in this systematic review and meta-analysis, we evaluated the impact of baseline levels of HBsAg on achieving a functional cure in patients with chronic hepatitis B (CHB).</div></div><div><h3>Materials and Methods</h3><div>We searched PubMed, Embase, and the Cochrane Library up to December 31, 2023, to identify studies comparing combination therapy with nucleos(t)ide analogues (NAs) and conventional/pegylated interferon (IFN) <em>versus</em> monotherapy. We pooled the proportions of HBsAg loss among studies stratified by different 75^th percentile of baseline HBsAg levels and other clinical characteristics.</div></div><div><h3>Results</h3><div>We included 24 studies with 3446 participants. At the end of treatment, studies recruiting patients with 75^th percentile of baseline HBsAg below 500 and 1000 IU/mL had the highest proportions of HBsAg loss in the combination group, reaching 14 % (95 % CI: 9–21 %) and 17 % (95 % CI: 10–24 %), respectively. One-year IFN-NAs combination treatment achieved a higher proportion of HBsAg loss (9 %, 95 % CI: 6–12 %) than six-month IFN-NAs treatment (1 %, 95 % CI: 0–2 %). Patients with normal alanine transaminase (ALT) had higher HBsAg loss (11 %, 95 % CI: 6–17 %) than those with elevated ALT (4 %, 95 % CI: 2–7 %). Meta-regression indicated a positive association between male percentage in studies and HBsAg loss.</div></div><div><h3>Conclusions</h3><div>The optimal baseline HBsAg thresholds would be 500–1000 IU/mL, which represents high-response subpopulations for achieving a functional cure with currently available therapy.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101921"},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide for the treatment of post transplantation diabetes mellitus in patients following liver transplantation is safe and effective.","authors":"Daphne Bot, Bart van Hoek, Maarten E Tushuizen","doi":"10.1016/j.aohep.2025.101920","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101920","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101920"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of percentile curves of serum alanine aminotransferase in older adults: A multi-cohort study.","authors":"Yu Zhang, Shuwen Li, Kang Fu, Kailu Fang, Luyan Zheng, Yushi Lin, Yang Zheng, Jie Wu","doi":"10.1016/j.aohep.2025.101918","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101918","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Age independently impacts alanine aminotransferase (ALT) levels. This study was conducted to develop age- and sex-specific ALT percentile curves among older adults and evaluate their diagnostic performance across two external cohorts.</p><p><strong>Materials and methods: </strong>We developed ALT percentile curves using data from a reference population aged 50-90 years (n = 20,039). We evaluated diagnostic performance of various ALT thresholds (40 U/L, American College of Gastroenterology [ACG]'s 33 U/L [men] and 25 U/L [women], and the new percentile curves) for infections of hepatitis B virus and hepatitis C virus, metabolic dysfunction associated steatotic liver disease, and excessive alcohol consumption in two external cohorts.</p><p><strong>Results: </strong>ALT percentile curves declined with age. In men, the 95th percentile decreased from 31.4 U/L at 50 years to 21.7 U/L at 90 years; in women, from 26.1 U/L to 17.8 U/L. The 95th percentile curves achieved the highest Youden's index and area under the receiver operating characteristic (AUROC) across the three thresholds in two external validation cohorts, with the Youden's index and AUROC of 0.141 and 0.571 (95% CI: 0.555-0.586) in external cohort 1, and 0.435 and 0.717 (95% CI: 0.680-0.754) in external cohort 2, respectively.</p><p><strong>Conclusions: </strong>The newly proposed ALT percentile curves may serve as a valuable reference for screening liver diseases in older adults.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101918"},"PeriodicalIF":3.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world insights into cabozantinib efficacy in hepatocellular carcinoma: Real-world cabozantinib efficacy in HCC.","authors":"Kuan-Chang Lai, Te-Lin Hsu, Shih-Yao Lin, Nai-Jung Chiang, Ming-Huang Chen, Yee Chao, Muh-Hwa Yang, San-Chi Chen","doi":"10.1016/j.aohep.2025.101917","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101917","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Cabozantinib, a multi-kinase inhibitor targeting AXL and MET, is approved for second-line treatment of hepatocellular carcinoma (HCC). However, the combination of cabozantinib with immune checkpoint inhibitors (ICIs) remains controversial after the COSMIC-312 study. The role of AXL and MET expression in predicting cabozantinib response is unclear. This study aims to evaluate cabozantinib's efficacy with ICIs and the predictive value of AXL and MET expression.</p><p><strong>Materials and methods: </strong>From January 2019 and December 2023, 50 advanced HCC patients treated with cabozantinib were retrospectively enrolled.</p><p><strong>Results: </strong>Overall, 74% of patients received prior immunotherapy, 72% had been treated with more than two different multiple kinase inhibitors (MKIs), and 58% received cabozantinib as a fifth-line or later therapy. Cabozantinib was used alone (60%), with ICIs (12%), or with chemotherapy (28%). A majority (70%) received a dosage exceeding 40 mg/day. The ORR to cabozantinib was 0%, while the DCR was 42.2%. median PFS was 3.3 months, and OS was 6.1 months. There was no significant difference in PFS or OS between patients receiving five or more lines of treatment and those receiving fewer. Cabozantinib plus ICIs showed longer PFS (6.7 vs. 3.2 months, p = 0.04) and a trend toward improved OS compared to cabozantinib alone. AXL expression may predict better outcomes. Common adverse effects included palmar-plantar erythrodysesthesia (24.2%) and hypertension.</p><p><strong>Conclusions: </strong>This study highlights the potential of cabozantinib combined with immunotherapy in heavily pretreated HCC, with AXL expression as a possible predictive biomarker.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101917"},"PeriodicalIF":3.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of non-hepatic cancers in biopsy-proven alcohol-related liver disease.","authors":"Mayur Brahmania, Zaid Hindi, Nancy Shi, Juan Pablo Arab, Neil Rajoriya, Guruprasad P Aithal, Michael Allison, Hannes Hagström, Alisa Likhitsup, Anne McCune, Steven Masson, Ewan Forrrest, Karin Oien, Beth Reed, Richard Parker","doi":"10.1016/j.aohep.2025.101908","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101908","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Alcohol-related liver disease (ALD) is a known contributor to non-hepatic cancers (NHC). We aimed to describe the incidence and predictors of NHC in patients with ALD.</p><p><strong>Materials and methods: </strong>The WALDO study is a multicenter cohort study of patients with histologically characterized ALD. Participants are followed from the time of liver biopsy and outcomes are captured from health records. The primary outcome was the incidence of the first NHC. Risk factors for NHC were presented as unadjusted and adjusted sub-distribution hazards (SDH) based on competing risk analysis. Statistical analyses were done in R.</p><p><strong>Results: </strong>691 patients were included. The median age was 51 years (IQR 43- 59), 427 (62 %) patients were male and 406 (59 %) had cirrhosis on biopsy. During a median follow-up of 4.7 years (IQR 1.2-9.5 years), 76 patients (11 %) with ALD developed NHC. The cumulative incidence of NHC in ALD was 2.4 % (1.4-3.9 %) over five years. The most common NHC was respiratory (18 cases, 23 % of NHC) followed by digestive tract (17 cases, 22 %) and cancers of the head and neck (13 cases, 17 %). On multivariable analysis, increasing age (SDH 1.04; CI 1.01-1.06; p = 0.011), previous smoking (SDH 3.65, CI 1.44-9.65; p = 0.006) and current smoking (SDH 3.14; CI 1.27-7.74; p = 0.013) were associated with a higher risk of NHC.</p><p><strong>Conclusion: </strong>NHC is common and frequently fatal. However, NHC is an infrequent cause of morbidity or mortality in ALD compared to liver-related outcomes.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101908"},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic liver disease in a third level hospital","authors":"Luis A. Torrez-Arias,&nbsp;Maria F. Higuera-De la Tijera","doi":"10.1016/j.aohep.2025.101860","DOIUrl":"10.1016/j.aohep.2025.101860","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Polycystic liver disease is part of a group of rare congenital disorders that result from altered development of the embryonic ductal plate. The prevalence is 1/10,000 to 1/158,000. The objective is to describe the characteristics of patients with polycystic liver disease at the General Hospital of Mexico.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;Observational, cross-sectional, descriptive study, case series type, during the period from January 2018 to May 2024, carried out in the outpatient clinic of the liver clinic in the Gastroenterology service of the General Hospital of Mexico “Dr. “Eduardo Liceaga.” Patients over 18 years of age who had at least one imaging study (ultrasound of the liver and bile ducts, computed tomography of the abdomen, magnetic resonance imaging of the abdomen) where characteristic imaging data of hepatic cysts with a number equal to or greater than 10 were identified. According to findings, it was classified according to Gigot and also as autosomal dominant polycystic liver disease (ADPD) and autosomal dominant polycystic kidney disease (ADPD). The clinical records were collected, the following data were collected: sex, age, body mass index, comorbidities, a history of family members with polycystic liver and/or kidney disease, the presence of high blood pressure, unintentional weight loss, studies were intentionally collected. laboratory tests of liver biochemical tests, extrahepatic symptoms, complications of polycystic disease and previous treatments, if they are in the transplant protocol. The statistics of the liver clinic offices were reviewed. Frequencies and percentages were used to summarize qualitative variables and mean and standard deviation were used for quantitative variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;During the period from January 2018 to May 2024, 56 patients were included, the majority of women (83.9%). With an average age of 58.8 ±20 years. Of them, 26.8% as EPHAD, and 73.2% are associated with EPRAD. 12 patients with Gigot III. No weight loss in 92.8%. 25% with a family history of polycystic kidney and/or liver disease. The most frequent comorbidity was SAH in 44.6% followed by those who did not present comorbidities in 39.3%. The most frequent symptom was abdominal pain in 26.8%, followed by abdominal distention and early satiety in 14.3 and 12.5% respectively and asymptomatic patients in 44.6%. Complications were presented as cyst infection and bile duct obstruction, which corresponds to 3.6%. The results of the analysis up to 5.4% with alteration of the synthesis function, 5.4% with alteration of the transaminases, in the blood count 5.4% between mild and moderate anemia, 3.6% with leukocytosis, 7.1% with thrombocytopenia, the Renal function was altered in 32.2%, and dyslipidemia was recorded in 17.9 to 35.7%. In statistics of the liver clinic outpatient consultation, 61,493 consultations were granted, and the prevalence is calcu","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101860"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between malnutrition determined by hand grip strength and the presence of minimal hepatic encephalopathy in women with liver cirrhosis","authors":"Valeria Rangel-Espinosa ,&nbsp;Marlene López-Sánchez ,&nbsp;Aldo Allende-López ,&nbsp;Nayeli Ortiz-Olvera ,&nbsp;Aleida Bautista-Santos ,&nbsp;Rosalba Moreno-Alcántar ,&nbsp;Segundo Morán","doi":"10.1016/j.aohep.2025.101821","DOIUrl":"10.1016/j.aohep.2025.101821","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Minimal hepatic encephalopathy (MHE) represents the initial stage within the spectrum of hepatic encephalopathy (HE). Its presence has been linked to muscular alterations: a reduction in the Skeletal Muscle Index was observed in 84% of MHE patients. Moreover, between 41-49% of individuals with MHE exhibit muscle depletion, as indicated by their mid-arm muscle circumference (MAMC) falling below the 5th percentile. Hand grip strength (HGS) serves as a marker of muscle functionality; however, the relationship between HGS values and the presence of MHE remains uncertain. Therefore, this study aims to achieve two primary objectives: 1) to establish a cut-off value for classifying malnutrition based on HGS measurements and 2) to investigate the association between malnutrition, as determined by HGS and the presence of MHE.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;This cross-sectional study enrolled 241 female participants from the Gastroenterology department at Hospital de Especialidades of Centro Médico Nacional Siglo XXI. Eligible participants were aged between 18 and 76 years and diagnosed with liver cirrhosis of any etiology, excluding cases related to excessive alcohol consumption. Exclusion criteria included recent antibiotic use (&lt;1 month), chronic kidney disease, elevated creatinine levels, hepatocellular carcinoma, illiteracy, and a history of hepatic encephalopathy (HE) or current decompensation due to variceal hemorrhage. Various parameters, including chronometric, clinical, biochemical, anthropometric, and dietary factors, were assessed. The determination of the malnutrition cut-off point based on hand grip strength was established using tertiles, and the association between these values and Minimal Hepatic Encephalopathy (MHE) was evaluated through logistic regression analysis. Statistical calculations were performed using the SPSS© 27 software.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The median age of the participants was 59 years (interquartile range 52-63). Among subjects, 168/241 (50.8%) individuals with liver cirrhosis had hepatitis C virus as an associated factor, while 136/241 (56.4%) were classified as stage 2 cirrhosis, and 37/241 (15.4%) presented with ascites. Furthermore, 36/ 241 (14.9%) participants were diagnosed with MHE. The threshold for identifying malnutrition based on HGS was established as the values falling within the lowest tertile of the sample (&lt;16.5 kg), resulting in 76/241 (31.5%) individuals being classified as malnourished. Malnutrition showed an association with the presence of MHE, OR: 2.214 (95% CI: 1.077-4.552, p=0.031). Adjustment of models for the presence of hyponatremia, BMI, CAMB, triceps skinfold, and Child-Pugh score did not alter this association. However, when accounting for albumin levels (g/dl), both malnutrition and albumin levels were independently associated with the presence of MHE [Malnutrition OR: 2.104, 95% CI 1.014-4.364, p=0.046","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101821"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal muscle as a source of IGFBP-2 in a murine model of metabolic dysfunction associated with steatotic liver disease.","authors":"Miriam G. Bautista-Ubaldo ,&nbsp;Bryan M. Ata-Calixto ,&nbsp;Diana Paola Osnaya-Burgos ,&nbsp;Ignacio González-Sánchez ,&nbsp;Gabriela Gutiérrez-Reyes ,&nbsp;Carolina Guzmán","doi":"10.1016/j.aohep.2025.101822","DOIUrl":"10.1016/j.aohep.2025.101822","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Insulin-like Growth Factor Binding Protein (IGFBP)-2 is lower in serum during obesity and metabolic dysfunction. We have previously shown that the decrease in serum IGFBP-2 follows a diminished expression in liver and heart, both associated with the progression of steatotic liver disease. We aimed to identify, in a murine model, the synthesis of IGFBP-2 in extrahepatic tissues involved in metabolic dysfunction: skeletal muscle and adipose tissue.</div></div><div><h3>Materials and Patients</h3><div>Samples of hamstring muscle, and epididymal adipose tissue were obtained from male C57BL/6 mice, fed a high-fat diet supplemented with sucrose and fructose (42g/L) in the beverage during 6 months. All procedures were approved by the Institutional Committee of Care and Use of Laboratory Animals at the School of Medicine, UNAM (FM/DI/005/2022). Four groups were included: Control; Metabolic dysfunction (MD), exhibiting increased bodyweight and adiposity; MD with steatosis (MD+SS); and MD+SS with fibrosis (MD+SS+F). Total protein was isolated in a protease inhibitor cocktail. Protein integrity was assessed by SDS-PAGE. IGFBP-2 was assayed by ELISA. Data was shown as Mean±SD, analyzed by one-way ANOVA; Student´s t test was applied to compare 2 groups. P&lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>IGFBP-2 expression was 6-fold increased in control skeletal muscle compared to control adipose tissue. In epididymal adipose tissue, IGFBP-2 expression significantly decreased in MD+SS+F compared to Controls, and MD. In contrast, the hamstring showed increased IGFBP-2 expression in mice showing metabolic dysfunction associated with steatotic liver disease: MD+SS and MD+SS+F. The percentage of adiposity significantly increased in MD subjects whereas no changes were observed regarding muscle mass, suggesting hypertrophy might be key.</div></div><div><h3>Conclusions</h3><div>Our results show that metabolic dysfunction (MD) associated with MASLD have a role in inhibiting IGFBP-2 expression in adipose tissue. In contrast, skeletal muscle increases its synthesis. These results suggest a role for skeletal muscle in the reversion of MASLD through IGFBP-2 expression. More studies are needed to identify the roles of skeletal muscle and its hypertrophic state in MASLD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101822"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of MELD Scores as Predictors of Mortality in Patients with Decompensated Chronic Liver Disease with Variceal Hemorrhage at a third-level care center.","authors":"Laura V. Cupil-Escobedo,&nbsp;Karina Cazarin-Chavez,&nbsp;María F. Higuera-De La Tijera","doi":"10.1016/j.aohep.2025.101873","DOIUrl":"10.1016/j.aohep.2025.101873","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The variceal hemorrhage is the most common cause of decompensation in patients with chronic liver disease. Hemoglobin level has been used to classify severity; however, it is unreliable. This study aims to evaluate MELD scores as predictors of mortality in patients with variceal hemorrhage.</div></div><div><h3>Materials and Patients</h3><div>An observational, retrospective, comparative, and longitudinal study was conducted on patients hospitalized in the Gastroenterology department for one year, who were admitted with a diagnosis of variceal hemorrhage and met the criteria for applying the MELD score within the first 48 hours of hospitalization. Descriptive and inferential statistics were performed using ROC curves. Demographic variables, MELD, MELD Na, and MELD Lactate scores were evaluated. The initial and follow-up hemoglobin levels were assessed. Additionally, hospitalization days and discharge reasons were considered.</div></div><div><h3>Results</h3><div>A total of 96 patients were analyzed (60 women and 36 men) with an average age of 62 ± 8 years. Regarding the etiology of cirrhosis, Alcohol: 48, MASLD: 18, METALD: 8, Viral: 4, Unspecified: 6, Autoimmune: 16. In the analysis of ROC curves, it was found that there was a significant mortality prediction for the MELD, MELD Na, and MELD Lactate models. The MELD cutoff of 21.5 points presented an AUROC of 0.866 (95% CI: 0.71-1.00, p= &lt;0.001), MELD Na of 20.5 had an AUROC of 0.848 (95% CI: 0.67-1.00, p= &lt;0.001), and the MELD Lactate cutoff of 20.5 had an AUROC of 0.791 (95% CI: 0.644-0.939, p= 0.003)</div></div><div><h3>Conclusions</h3><div>In the analysis of ROC curves, the MELD, MELD Na, and MELD Lactate models demonstrated a significant predictive capacity for mortality. The AUROC values were 0.866, 0.848, and 0.791 respectively, confirming their utility in clinical practice for patients with chronic liver disease admitted in the context of decompensation due to variceal bleeding.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101873"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}